Question

Filed in 2002 in Indiana, Joseph E. Doescher claimed that Daniel H. Raess, MD, yelled at him while in the work setting. Both men worked at St. Francis Hospital and Health Centers in Beech Grove, Indiana. The suit claims that Dr. Raess, a heart surgeon at St. Francis, came toward Doescher, a perfusionist, who backed up and put out his hands to protect himself. The hospital was not named in the suit. Kevin Betz, Doescher’s attorney, called in an expert witness to testify it was a bullying incident. “[Doescher] was severely depressed and unable to go back to work” after the incident, Betz said. In March, a jury in Marion (Ind.) Superior Court ordered Dr. Raess to pay $325,000 to Doescher, who no longer works in health care. Experts who have studied the subject said it was a significant decision in a growing, yet murky, area of law. The case may make physicians re-examine how they interact with coworkers as the courts begin to legally define what constitutes workplace bullying. The Doescher case has implications for how physicians treat their coworkers and how coworkers treat each other. It sends a message to all hospital employees that if they step over a certain line of civility, they could find themselves on the wrong end of a lawsuit. It may embolden employees to take action if they believe they are receiving rude and abrasive treatment. Defining Workplace Bullying Experts say the case should prompt hospitals, physicians, nurses, and all employees to re-evaluate what might be considered bullying in the health-care setting. It is important to let employees know what the conduct policy is and have them acknowledge that they have read and understand it. Health-care attorneys believe that labor laws cover abusive behavior and discrimination, but workplace bullying is an emerging area that has yet to be clearly defined by courts. Workplace bullying is being used as a catch phrase for behaviors that have existed for a long time in health-care settings. Older nurses will tell you that workplace bullying has been around since they were students and is a persistent form of hostility from physicians to nurses and older nurses to younger nurses. The phrase, “eating your young,” grew from this type of behavior, which is frequent and lasts over a long period of time. Studies show that more than 14 percent of health-care workers experienced bullying some time during their careers. Health-care institutions seem to be hotspots for bullying because of the hierarchical nature of the command structure. Medical and nursing school students are often harassed or abused by instructors and supervisors. There is a growing recognition among administrators and managers that hospitals and physician offices must abide by laws that prevent certain types of uncivil behavior. But the issue is complicated because many physicians at hospitals are independent contractors not bound by normal employee policies.
What Is Bullying? Researchers and health-care attorneys say workplace bullying is a vague legal area that is hard to define. Nonetheless, here are some behaviors that could indicate bullying on the job:
· Persistent hostility toward an employee
· Behavior that occurs on more than one occasion and continues over time
· Aggressive behavior that interferes with an employee’s work production
· Regular verbal attacks toward one employee but not others
· Physical threats on numerous occasions
· Yelling or shouting in a hostile manner
· Violations of conduct standards spelled out by the employer
 
Questions for Thought
 
1. Would a nurse consider a physician a bully for yelling at him or her while the doctor is trying to save a client’s life in the emergency department during a code blue? Is there any alternative to yelling in stressful situations or is it acceptable?
2. What types of behaviors can be viewed as just disrespectful and not bullying, and therefore not illegal? List the behaviors and justify the reason you believe so.
3. Add to the list above what you would consider bullying in the work setting.

Answer 1

Answer) In my opinion, a nurse would not consider a physician a bully for yelling at him/her in critical situations like code blue because in this context yelling should be seen as a "call out" for an emergency. The nurse should understand the mental status of the physicians during such events, like, maybe the doctor is panicking and anxious at that moment and he yelled without even having an intention to hurt the nurse. But if this behavior continues to occur several times and in situations which are not that stressful, then the nurse may consider it bullying.

I personally think that there can be alternatives to prevent this yelling, for instance the nurse can directly communicate his/her discomfort with that particular doctor after the client has been treated. And for physicians I'd advice practicing self control techniques, or do some meditation which would prevent them from losing their temper in stressful situations.